Healthcare Provider Details

I. General information

NPI: 1043932486
Provider Name (Legal Business Name): HOSPITALIST MEDICINE PHYSICIANS OF OKLAHOMA TCS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2022
Last Update Date: 03/07/2025
Certification Date: 03/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5602 SW LEE BLVD
LAWTON OK
73505-9635
US

IV. Provider business mailing address

120 BRENTWOOD COMMONS WAY STE 510
BRENTWOOD TN
37027-2028
US

V. Phone/Fax

Practice location:
  • Phone: 580-531-4700
  • Fax:
Mailing address:
  • Phone: 615-377-1674
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: LAURA FALL
Title or Position: MANAGER
Credential:
Phone: 253-682-6040